image: Roger D. Weiss, M.D., is the Chief of the Division of Alcohol and Drug Abuse at McLean Hospital in Massachusetts. view more
Credit: McLean Hospital
Hazelden's Butler Center for Research has awarded Roger D. Weiss, M.D., Chief of the Division of Alcohol and Drug Abuse at McLean Hospital in Massachusetts its latest "Dan Anderson Research Award" for his study examining the effectiveness of long-term buprenorphine maintenance accompanied by adjunctive counseling in the treatment of prescription opioid drug dependence.
This important award honors a single published article by a researcher who has advanced the scientific knowledge of addiction treatment and recovery.
Dr. Weiss earned the award for his study, "Adjunctive Counseling During Brief and Extended Buprenorphine-Naloxone Treatment for Prescription Opioid Dependence," published in 2011 in the Archives of General Psychiatry. The study looked at over 650 individuals who were dependent on prescription opioids and sought outpatient treatment. All study participants received buprenorphine-naloxone and were randomly assigned to either standard medical management or standard medical management accompanied by opioid dependence counseling. In Phase I of the study, all participants received a two-week buprenorphine stabilization followed by a two-week taper. Participants who had an unfavorable outcome in Phase 1 were given an additional 12 weeks of buprenorphine maintenance followed by a four-week taper. In both phases, the study assessed opioid drug use during the first eight weeks after discontinuation of buprenorphine via self-report assessments and urinary drug screens.
"Abuse of prescription opioids is a significant public health and policy concern, with increasing rates of nonmedical use, emergency department visits, addiction treatment episodes, overdose deaths and costs related to these drugs in recent years" said Weiss. "The present findings raise an important question: what length of buprenorphine-naloxone treatment, if any, would lead to substantially better outcomes after a taper?"
Dr. Shelly F. Greenfield, director, Clinical and Health Services Research, Division of Alcohol and Drug Abuse at McLean Hospital nominated Dr. Weiss for the award, calling his paper "an example of Dr. Weiss' research career and its contribution to the advancement of scientific knowledge of addiction recovery."
The multisite study produced several interesting and noteworthy results. In Phase I, wherein participants received two weeks of buprenorphine followed by a two week taper, less than 7% of participants had favorable opioid use outcomes. In contrast, 49% of Phase II participants who received 12 weeks of buprenorphine followed by a four-week taper had positive opioid use outcomes while they were taking buprenorphine. However, success rates dropped substantially during the eight weeks following the end of the buprenorphine taper. The study also found that participants receiving standard medical management did not have better outcomes than patients receiving medical management and adjunctive opioid counseling, though Weiss and colleagues state that more frequent counseling over a longer period of time may have produced more positive results. They also stated that it is currently unclear whether longer term buprenorphine treatment before initiation of the taper would have produced better outcomes. Finally, the presence of chronic pain in some participants did not affect opioid use outcomes.
"Our Scientific Panel of Advisors was extremely impressed with the scientific rigor of this study, its two phase methodology, and the fact it examined extended buprenorphine maintenance," stated Dr. Audrey Klein, director of the Butler Center for Research at the Hazelden Foundation. "His current work on the use of long-term buprenorphine is innovative, timely, and essential given the current epidemic of prescription opioid addiction and increase in deaths related to opioid overdose."
Dr. Weiss will accept the award and a $2,000 honorarium from Hazelden later this year. The award is named for the late Dan Anderson, Ph.D., the former president of Hazelden and one of the major architects of the Minnesota Model, the interdisciplinary approach to addiction treatment that has been implemented worldwide.
Weiss' research was selected as the best from among several outstanding candidates by the Scientific Panel of the Butler Center for Research. The panel includes Klein; Valerie Slaymaker, Ph.D., Chief Academic Officer and Provost of the Hazelden Graduate School of Addiction Studies; Carlton Erickson, Ph.D., University of Texas-Austin; Lee Ann Kaskutas, Dr.PH, Alcohol Research Group, Emeryville, Calif.; Stephanie O'Malley, Ph.D., Yale University; Jon Morgenstern, Ph.D., National Center on Addiction and Substance Abuse, New York; John Finney, Ph.D., Center for Healthcare Evaluation, VA Palo Alto Health Care System; John F. Kelly, Ph.D., Massachusetts General Hospital, Psychiatry; and Constance Weisner, Ph.D., University of California-San Francisco.
About Hazelden
Recognizing outstanding research and conducting research of its own are the primary objectives of the Butler Center for Research, the research arm of Hazelden. Founded in 1949, Hazelden is a national nonprofit organization that helps people reclaim their lives from the disease of addiction. With over 60 years of knowledge and experience, Hazelden offers a comprehensive approach to addiction that addresses the full range of patient, family, and professional needs, including treatment and continuing care for youth and adults, research, higher education, public education and advocacy, and publishing. Learn more at http://www.hazelden.org.